Rethinking Antibiotic Use In Children (Archived Pedcast)

Topic Introduction

There is a fascinating new study in Pediatrics April 2015 that raises new questions about a medical tool that has been around for almost 100 year, antibiotics. First discovered in the 1930s, antibiotics have undoubtedly saved millions of lives and have been a great tool for medical science. Until recently, doctors and scientists thought of antibiotics as targeted weapons that are able to selectively destroy germs that our bodies were fighting, invasive germs, and leave the host, your child, with a balance of healthy bacteria, so called normal flora.

Recently these assumptions have started to be questioned because of an observation that farmers have known about for 60 years which is… that giving small amounts of antibiotics to growing farm animals makes them get fatter and bigger than those animals that don’t get them. I think until recently that farmers assumed that these antibiotics just made the animals less sick and therefore able to grow bigger but now scientists are changing their mind about that. The new thinking, backed up by this recent data in the Journal Pediatrics, indicates that very young children who get broad spectrum antibiotics very early in life, have a greater risk of being obese by age two than children around them raised in similar circumstances. Just an association, but interesting.

How Do Antibiotics Affect Children’s Health?

If we assume this is true why should this be? What is it about antibiotics early in life that make animals and children bigger?  The current belief by many is that these antibiotics change the kind of “normal flora” the child or animal carries in their gut and changes the way the child digests food. For hard-core listeners, you might remember that we talked about in the book review I did of Dr. Martin Blaser’s book, The Missing Microbes. It seems like the recent data is validating that thinking. Not only did the data find that antibiotics had a growth promoting effect in children, but the more potent the antibiotics and the more exposure, the bigger the growth promotion effect. I think this is powerful evidence that this is not just an association effect but also a real effect of the antibiotics.

Finding the Balance

So what useful information can parents get from all this. Here is what I think; If you have a child less than two years of age who is sick and needs antibiotics, have a conversation with your child’s pediatrician about the potency and length of treatment that should be used. Antibiotics are here to stay when it comes to children but in the past 10 years, pediatricians are trying to pull back on their use, trying to hit the bare minimum without jeopardizing a child’s health.  I know those parents that oppose vaccines don’t want to hear it, but vaccines are our best way of reducing exposure to antibiotics by preventing the infection from ever happening. You know that Doc Smo pearl; Prevention trumps treatment, every time!  Certainly true here.

As always, thanks for joining me today. I would love to hear from you and I would appreciate you taking a minute to subscribe to at my website or on iTunes. This is Dr. Paul Smolen, hoping I can keep you in the loop, with the latest medical scoop. Until next time.

Smo Notes:

1.Antibiotic Exposure in Infancy and Risk of Being Overweight in the First 24 Months of life

Pediatrics Volume 135, number 4, April 2015

  1. The Missing Microbes by Martin Blazer, Henry Holt and Company, New York, 2014

3.Missing Microbes, by Martin Blaser MD (Book Review Pedcast) – See more at: